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Many otherwise healthy people who report symptoms suggestive of reactive hypoglycemia in fact "feel hypoglycemic" when plasma glucose is still in the normal range. This double-blind study suggests that caffeine is one factor that may modulate the perception of hypoglycemia.
Researchers induced hypoglycemia in eight healthy young adults by infusing glucose and insulin on two separate occasions -- once after drinking diet cola with 400 mg of caffeine and once after drinking caffeine-free cola. When plasma glucose levels dropped from 90 mg/dl (5 mmol/l) to 68 mg/dl, subjects felt hypoglycemic symptoms only after they had ingested caffeine. When glucose levels further declined to 50 mg/dl, symptoms occurred after either beverage, but were worse …